scholarly journals Boosting Humoral Immunity from mRNA COVID-19 Vaccines in Kidney Transplant Recipients

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 56
Author(s):  
Leszek Tylicki ◽  
Alicja Dębska-Ślizień ◽  
Marta Muchlado ◽  
Zuzanna Ślizień ◽  
Justyna Gołębiewska ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Secondary Analysis ◽  
Humoral Response ◽  
Primary Vaccination ◽  
Transplant Recipients ◽  
Igg Antibodies ◽  
Kidney Transplant Recipients ◽  
Serious Adverse Events ◽  
The Third ◽  
Longitudinal Observational Study

Introduction: The immune response to the primary (two-dose) series of mRNA COVID-19 vaccines in kidney transplant recipients (KTRs) is very weak. We conducted a longitudinal observational study to compare the humoral response to a third, additional primary dose of mRNA vaccines between infection-naïve (IN-KTRs) and previously infected KTRs (PI-KTRs). Methods: We measured the levels of anti-spike (anti-s) IgG antibodies before and 14–21 days after the third dose and, in the secondary analysis, we compared the antibody response to BNT162b2 versus mRNA-1273. The reactogenicity assessment included solicited local and systemic reactions. Results: A total of 112 KTRs were enrolled, including 83 IN-KTR and 29 PI-KTR, among whom seroconversion in anti-s antibodies after the primary two-dose vaccination was achieved in 45.78% and 100% of cases, respectively. After three months, a waning antibodies titer by 67.4% (IN-KTR) and 7.5% (PI-KTR) was observed. After the third dose of the mRNA vaccine, 71.08% (59/83) of IN-KTR and 96.5% (28/29) of PI-KTR samples were seroconverted with a median anti-s titer of 468.0 (195.0–1620.0) BAU/mL and 1629.0 (1205–1815) BAU/mL, respectively. Of those IN-KTR in whom the primary vaccination failed, 46.67% (21/45) of patients achieved seroconversion after the third dose. No serious adverse events after the third dose were reported. In strata analyses, after the third dose, 66% (40/60) of patients vaccinated with BNT162b2 and 82.6% (19/23) of patients vaccinated with mRNA-1273 seroconverted with a median anti-s titer of 384.5 (144–837) BAU/mL and 1620 (671–2040) BAU/mL, respectively. Conclusions: The use of a third dose of mRNA vaccine may be of benefit for KTR, especially for those in whom the primary vaccination failed. Vaccines with a higher dose of mRNA and a longer interval between doses of the primary vaccination, such as mRNA-1273, seem to be the preparations of choice in immunocompromised individuals.

scholarly journals Seroprevalence of SARS-CoV-2 IgG Antibodies After the Second BNT162b2 mRNA Vaccine in Japanese Kidney Transplant Recipients

2021 ◽  
Author(s):  
Tomoko Hamaya ◽  
Shingo Hatakeyama ◽  
Tohru Yoneyama ◽  
Yuki Tobisawa ◽  
Hirotake Kodama ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Kidney Transplant ◽  
Neutralizing Antibodies ◽  
Humoral Response ◽  
Healthy Controls ◽  
Transplant Recipients ◽  
Igg Antibodies ◽  
Kidney Transplant Recipients ◽  
Univariate Logistic Regression Analysis ◽  
Antibody Titers

Abstract We aimed to evaluate the rate of anti–SARS-CoV-2 IgG seropositivity and investigated factors associated with seropositivity after the second SARS-CoV-2 mRNA vaccination in kidney transplant (KT) recipients. This retrospective study conducted between June 2021 and November 2021 included 106 KT recipients and 127 healthy controls who received the second dose of the BNT162b2 mRNA vaccine at least seven days before the measurement of antibody titers. The titers of immunoglobulin G (IgG) antibodies against the receptor-binding domain of SARS-CoV-2 spike (S) protein were determined. Seropositivity was defined as an anti–SARS-CoV-2 IgG level of ≥15 units/mL, which was considered as the presence of sufficient neutralizing antibodies. The median ages and the seroprevalence rates of the healthy controls and KT recipients were 68 and 56 years and 98% and 22%, respectively. Univariate logistic regression analysis revealed that age >53 years, rituximab use, mycophenolate mofetil use, and KT vintage <7 years were negatively associated with anti–SARS-CoV-2 IgG seropositivity in KT recipients. Humoral response after the second BNT162b2 mRNA vaccine was greatly hindered by immunosuppression therapy in KT recipients. Older age, rituximab use, mycophenolate mofetil use, and KT vintage may play key roles in seroconversion.

scholarly journals Predictors of Humoral Response to mRNA COVID19 Vaccines in Kidney Transplant Recipients: A Longitudinal Study—The COViNEPH Project

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1165
Author(s):  
Alicja Dębska-Ślizień ◽  
Zuzanna Ślizień ◽  
Marta Muchlado ◽  
Alicja Kubanek ◽  
Magdalena Piotrowska ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Seroconversion Rate ◽  
Booster Vaccination ◽  
Humoral Response ◽  
Transplant Recipients ◽  
Igg Antibodies ◽  
Kidney Transplant Recipients ◽  
Younger Age ◽  
Subgroup Analyses ◽  
Immunosuppressive Protocol

Background: The efficacy of SARS-CoV-2 vaccination among kidney transplant recipients (KTR) is low. The main goal of this study was to analyze factors that may influence the humoral response to vaccination. Methods: We analyzed the titer magnitude of IgG antibodies directed against spike (S)-SARS-CoV-2 antigen after the second dose of the mRNA vaccine in 142 infection naïve KTR (83 men, i.e., 58.4%) with a median age (IQR) of 54 (41–63), and 36 respective controls without chronic kidney disease. mRNA-1273 or BNT162b2 were applied in 26% and 74% of KTR, respectively. Results: S-specific immune response (seroconversion) was seen in 73 (51.41%) of KTR, and in all controls 36 (100%). Independent predictors of no response were elder age, shorter transplantation vintage, and a more than two-drug immunosuppressive protocol. In subgroup analyses, the seroconversion rate was highest among KTR without MMF/MPS treatment (70%), treated with no more than two immunosuppressants (69.2%), treated without corticosteroid (66.7%), younger patients aged <54 years (63.2%), and those vaccinated with the mRNA-1273 vaccine (62.16%). The independent predictors of higher S-antibody titer among responders were younger age, treatment with no more than two immunosuppressants, and the mRNA-1273 vaccination. Conclusions: Our study confirmed a low rate of seroconversion after vaccination with the mRNA vaccine in KTR. The major modifiable determinants of humoral response were the composition of the immunosuppressive protocol, as well as the type of vaccine. The latter could be taken into consideration when initial vaccination as well as booster vaccination is considered in KTR.

scholarly journals Predictive factors of response to 3rd dose of COVID-19 mRNA vaccine in kidney transplant recipients

2021 ◽  
Author(s):  
Xavier Charmetant ◽  
Maxime Espi ◽  
Thomas Barba ◽  
Anne Ovize ◽  
Emmanuel Morelon ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Response Rate ◽  
Individual Variability ◽  
Spike Protein ◽  
Receptor Binding Domain ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Optimal Response ◽  
The Third ◽  
Response Increase

AbstractOnly a minority of kidney transplant recipients (KTRs) develop protective neutralizing titers of anti-receptor binding domain of spike protein (RBD) IgG after two doses of mRNA COVID-19 vaccine. Administration of a third dose of mRNA vaccine to KTRs with sub-optimal response increase anti-RBD IgG titers but with high inter-individual variability. Patients with the higher response rate to the third dose of vaccine can be identified by the presence of low anti-RBD IgG titers and spike-specific CD4+ T cells in their circulation 14 days after the second dose.

scholarly journals Severely Disseminated Kaposi Sarcoma after ABO-Incompatible Kidney Transplantation Treated Successfully with Paclitaxel and Gemcitabine Combined with Hemodialysis

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Tobias Bomholt ◽  
Anders Krarup-Hansen ◽  
Martin Egfjord ◽  
Søren Schwartz Sørensen ◽  
Niels Junker
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Kaposi Sarcoma ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Serious Adverse Events ◽  
Human Herpes Virus 8 ◽  
Positron Emission ◽  
Vascular Proliferation

Kaposi Sarcoma (KS) is driven by human herpes virus 8 causing vascular proliferation which is induced by loss of immune function most often due to HIV or immunosuppressants. KS occurs with increased incidence in kidney transplant recipients, but rarely is disseminated. We report a 64-year-old male who developed severely disseminated KS 5 months after ABO-incompatible kidney-transplantation. No guidelines for chemotherapy exist in this case and reduced kidney function and impaired immune system complicates the use of systemic chemotherapy in kidney transplant recipients. A combination of paclitaxel and gemcitabine followed by two days of hemodialysis treatment was chosen since paclitaxel can be given in full dose independently of kidney function and gemcitabine is metabolised to 2′,2′-difluorodeoxyuridine which is found to be highly dialysable. The present treatment was well tolerated by the patient with one episode of leukopenia and elevated alanine transaminase during treatment which resolved. There were no serious adverse events and the patient obtained a complete remission verified by Positron Emission Tomography CT after ending chemotherapy and at one-year follow up.

scholarly journals B and T cell responses after a third dose of SARS-CoV-2 vaccine in Kidney Transplant Recipients

2021 ◽  
Author(s):  
Eva Schrezenmeier ◽  
Hector Rincon-Arevalo ◽  
Ana-Luisa Stefanski ◽  
Alexander Potekhin ◽  
Henriette Staub-Hohenbleicher ◽  
...  
Keyword(s):  
T Cell ◽  
Kidney Transplant ◽  
Immunosuppressive Treatment ◽  
Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
The Third ◽  
Cellular Analysis ◽  
Cell Immunity

Background: Accumulating evidence suggests that solid organ transplant recipients, as opposed to the general population, show strongly impaired responsiveness towards standard SARS-CoV-2 mRNA-based vaccination, demanding alternative strategies for protection of this vulnerable group. Methods: In line with recent recommendations, a third dose of either heterologous ChAdOx1 (AstraZeneca) or homologous BNT162b2 (BioNTech) was administered to 25 kidney transplant recipients (KTR) without humoral response after 2 doses of BNT162b2, followed by analysis of serological responses and vaccine-specific B- and T-cell immunity. Results: 9/25 (36%) KTR under standard immunosuppressive treatment seroconverted until day 27 after the third vaccination, while one patient developed severe COVID-19 infection immediately after vaccination. Cellular analysis seven days after the third dose showed significantly elevated frequencies of viral spike protein receptor binding domain specific B cells in humoral responders as compared to non-responders. Likewise, portions of spike-reactive CD4+ T helper cells were significantly elevated in seroconverting patients. Furthermore, overall frequencies of IL-2+, IL-4+ and polyfunctional CD4+ T cells significantly increased after the third dose, whereas memory/effector differentiation remained unaffected. Conclusions: Our data suggest that a fraction of transplant recipients benefits from triple vaccination, where seroconversion is associated with quantitative and qualitative changes of cellular immunity. At the same time, the study highlights that modified vaccination approaches for immunosuppressed patients still remain an urgent medical need.

scholarly journals Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
David Arroyo ◽  
Sindhu Chandran ◽  
Parsia A. Vagefi ◽  
David Wojciechowski
Keyword(s):  
Kidney Transplant ◽  
Randomized Trials ◽  
Bk Virus ◽  
Common Complication ◽  
Transplant Recipients ◽  
Retrospective Evaluation ◽  
Kidney Transplant Recipients ◽  
Serious Adverse Events ◽  
Initial Reduction ◽  
Bk Polyomavirus

Background. BK virus (BKV) infection is a common complication following kidney transplantation. Immunosuppression reduction is the cornerstone of treatment while adjuvant drugs have been tried in small uncontrolled studies. We sought to examine our center’s experience with the use of ciprofloxacin in patients with persistent BKV infection.Methods. Retrospective evaluation of the effect of a 30-day ciprofloxacin course (250 mg twice daily) on BKV infection in kidney transplant recipients who had been diagnosed with BK viruria ≥106 copies/mL and viremia ≥500 copies/mL and in whom the infection did not resolve after immunosuppression reduction and/or treatment with other adjuvant agents. BKV in plasma and urine was evaluated after 3 months following treatment with ciprofloxacin.Results. Nine kidney transplant recipients received ciprofloxacin at a median of 130 days following the initial reduction in immunosuppression. Three patients showed complete viral clearance and another 3 had a ≥50% decrease in plasma viral load. No serious adverse events secondary to ciprofloxacin were reported and no grafts were lost due to BKV up to 1 year after treatment.Conclusion.Ciprofloxacin may be a useful therapy for persistent BKV infection despite conventional treatment. Randomized trials are required to evaluate the potential benefit of this adjuvant therapy.

scholarly journals Humoral response to a 13-valent pneumococcal conjugate vaccine in kidney transplant recipients

Vaccine ◽  
2020 ◽  
Vol 38 (17) ◽  
pp. 3339-3350 ◽  
Author(s):  
Simon Oesterreich ◽  
Monika Lindemann ◽  
David Goldblatt ◽  
Peter A. Horn ◽  
Benjamin Wilde ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Humoral Response ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

scholarly journals Diminished antibody response against SARS-CoV-2 Omicron variant after third dose of mRNA vaccine in kidney transplant recipients

2022 ◽  
Author(s):  
Ayman Al Jurdi ◽  
Rodrigo Benedetti Gassen ◽  
Thiago De Jesus Borges ◽  
Isadora Tadeval Lape ◽  
Leela Morena ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Vaccine Dose ◽  
Antibody Responses ◽  
Transplant Recipients ◽  
Wild Type ◽  
Kidney Transplant Recipients ◽  
Specific Antibodies ◽  
Antiviral Responses ◽  
The Third ◽  
Donor Specific Antibodies

Abstract: Background: Available SARS-CoV-2 vaccines have reduced efficacy against the Omicron variant in immunocompetent individuals. Kidney transplant recipients (KTRs) have diminished antiviral responses to wild-type SARS-CoV-2 after vaccination, and data on antiviral responses to SARS-CoV-2 variants, including the Omicron variant, are limited. Methods: We conducted a prospective, multi-center cohort study of 51 adult KTRs who received three doses of BNT162b2 or mRNA-1273. Blood and urine samples were collected before and four weeks after the third vaccine dose. The primary outcome was anti-viral antibody responses against wild-type and variants of SARS-CoV-2. Secondary objectives included occurrence of breakthrough SARS-CoV-2 infection and non-invasive monitoring for rejection using serum creatinine, proteinuria, donor-derived cell-free DNA and donor-specific antibodies. Sera from pre-pandemic healthy controls and KTRs were used for comparison. Results: 67% of KTRs developed anti-wild-type spike antibodies after the third vaccine dose, similar to the Alpha (51%) and Beta (53%) variants, but higher than the Gamma (39%) and Delta (25%) variants. No KTRs had neutralizing responses to the Omicron variant before the third vaccine dose. After the third dose, fewer KTRs had neutralizing responses to the Omicron variant (12%) compared to wild-type (61%) and Delta (59%) variants. Three patients (6%) developed breakthrough SARS-CoV-2 infection at a median of 89 days. No KTRs developed allograft injury, de novo donor-specific antibodies or allograft rejection. Conclusion: In KTRs, a third dose of mRNA vaccines increases antibody responses against wild-type and variants of SARS-CoV-2, while neutralizing responses to the Omicron variant remain markedly reduced.

scholarly journals Real-world Effectiveness of 2-dose SARS-CoV-2 Vaccination in Kidney Transplant Recipients

2021 ◽  
Author(s):  
Caitriona M. McEvoy ◽  
Anna Lee ◽  
Paraish S. Misra ◽  
Gerald Lebovic ◽  
Ron Wald ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Transplant ◽  
Real World ◽  
Humoral Response ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
The Real ◽  
Transplant Program ◽  
The Impact

The humoral response to two doses of SARS-CoV-2 (Covid-19) vaccine among transplant recipients is inferior to immunocompetent individuals. Data on the real-world effectiveness of vaccination in kidney transplant recipients [KTRs] are lacking. We performed a cohort study to investigate the impact of vaccination on Covid-19 infection and outcomes in our kidney transplant program.

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